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Guideline update

Sui-Yuan Chang, Pi-Han Lin, Chien-Lin Cheng, Mao-Yuan Chen, Hsin-Yun Sun, Szu-Min Hsieh, Wang-Huei Sheng, Yi-Ching Su, Li-Hsin Su, Shu-Fang Chang, Wen-Chun Liu, Chien-Ching Hung, Shan-Chwen Chang
Antiretroviral therapy containing an integrase strand transfer inhibitor (INSTI) plus two NRTIs has become the recommended treatment for antiretroviral-naive HIV-1-infected patients in the updated guidelines. We aimed to determine the prevalence of INSTI-related mutations in Taiwan. Genotypic resistance assays were performed on plasma from ARV-naïve patients (N = 948), ARV-experienced but INSTI-naive patients (N = 359), and raltegravir-experienced patients (N = 63) from 2006 to 2015. Major INSTI mutations were defined according to the IAS-USA list and other substitutions with a Stanford HIVdb score ≧ 10 to at least one INSTI were defined as minor mutations...
October 25, 2016: Scientific Reports
Arun Kamal, Raja Bhaskara Kanakeshwar, Ashok Shyam, Dheenadayalan Jayaramaraju, Devendra Agraharam, Ramesh Perumal, Shanmuganathan Rajasekaran
PURPOSE: Open fractures are challenging injuries and there is a lot of variation in practice preferences which may reflect the wide variations in outcome in different units across the world. A survey was done amongst the international community of SICOT membership to document the practice preferences and variations. METHODS: An online questionnaire containing 23 questions which were sub-divided into three sections covering the various aspects of open injury management was sent by email to orthopaedic trauma surgeons across the world...
October 24, 2016: International Orthopaedics
Walid S Ayoub, Erica Cohen
Chronic hepatitis B is a worldwide disease, with significant burden on health care systems. While universal vaccination programs have led to an overall decrease in incidence of transmission of hepatitis B, unfortunately, there remain large areas in the world where vaccination against hepatitis B is not practiced. In addition, vertical transmission of hepatitis B persists as a major concern. Hepatitis B treatment of the pregnant patient requires a thorough assessment of disease activity and close monitoring for flares, regardless of initiation of antiviral therapy...
September 28, 2016: Journal of Clinical and Translational Hepatology
Daniel J Livorsi, Michihiko Goto, Margaret Carrel, Makoto M Jones, Jennifer McDanel, Rajeshwari Nair, Bruce Alexander, Brice Beck, Kelly K Richardson, Eli N Perencevich
OBJECTIVES: We sought to define regional variations in fluoroquinolone non-susceptibility (FQ-NS) among bloodstream isolates of Escherichia coli across the Veterans Health Administration (VHA) in the United States. METHODS: We analyzed a retrospective cohort of patients managed at 136 VHA hospitals who had a blood culture positive for E.coli between 2003 and 2013. Hospitals were classified based on US Census Divisions, and regional variations in FQ-NS were analyzed...
2016: Antimicrobial Resistance and Infection Control
D Costa Santos, F Barros, M Frazão, M Maia
Face burns expose patients to a higher respiratory risk, and early prophylactic intubation before they enter the burn unit might be life-saving. However, unnecessary intubation may compromise their clinical evolution. Hence, the decision to perform pre-burn centre endotracheal intubation remains a clinical challenge. A retrospective study was developed to characterize the experience of the tertiary burn unit of the Hospital da Prelada with face burn patients arriving endotracheally-intubated between January 2009 and September 2013...
December 31, 2015: Annals of Burns and Fire Disasters
R Aubry
On February 2, 2016, the French parliament adopted legislation creating new rights for the terminally ill. The text modifies and reinforces the rights of patients to end-of-life care and strengthens the status of surrogate decision makers. Under the new regulations, advance directives become legally binding though not unenforceable. Two types of advance directives are distinguished depending on whether the person is suffering or not from a serious illness when drafting them. The attending physician must abide by the patient's advance directives except in three situations: there is a life-threatening emergency; the directives are manifestly inappropriate; the directives are not compatible with the patient's medical condition...
October 21, 2016: Revue Neurologique
Eva de Berranger, Sandie Balcaen, Malika Ainaoui, Caroline Bompoint, Cécile Borel, Nathalie Chevallier, Natacha de Bentzmann, Virginie Denis, Karine Kerautret, Sandrine Godin, Marie-Laure Labat, Maïna Letort-Bertrand, Sophie Porcheron, Leonardo Magro, Ibrahim Yakoub-Agha, Myriam Guiraud
In an attempt to harmonize clinical practices among French hematopoietic stem cell transplantation centers, the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC) held its sixth annual workshop series in September 2015 in Lille. This event brought together practitioners from across the country. Our article discusses the updates and modifications for the 2016 version of the national patient follow-up care logbook.
October 21, 2016: Bulletin du Cancer
Stephen L Kopecky, Douglas C Bauer, Martha Gulati, Jeri W Nieves, Andrea J Singer, Peter P Toth, James A Underberg, Taylor C Wallace, Connie M Weaver
Description: Calcium is the dominant mineral present in bone and a shortfall nutrient in the American diet. Supplements have been recommended for persons who do not consume adequate calcium from their diet as a standard strategy for the prevention of osteoporosis and related fractures. Whether calcium with or without vitamin D supplementation is beneficial or detrimental to vascular health is not known. Methods: The National Osteoporosis Foundation and American Society for Preventive Cardiology convened an expert panel to evaluate the effects of dietary and supplemental calcium on cardiovascular disease based on the existing peer-reviewed scientific literature...
October 25, 2016: Annals of Internal Medicine
Dong Hoon Suh, Miseon Kim, Hak Jae Kim, Kyung Hun Lee, Jae Weon Kim
In 2015, fourteen topics were selected as major research advances in gynecologic oncology. For ovarian cancer, high-level evidence for annual screening with multimodal strategy which could reduce ovarian cancer deaths was reported. The best preventive strategies with current status of evidence level were also summarized. Final report of chemotherapy or upfront surgery (CHORUS) trial of neoadjuvant chemotherapy in advanced stage ovarian cancer and individualized therapy based on gene characteristics followed...
November 2016: Journal of Gynecologic Oncology
Alem Mehari, Alvin V Thomas, Alicia N Thomas, Mark S Johnson
Pulmonary hypertension (PH) is a leading cause of morbidity and early mortality in adults with sickle cell disease (SCD). However, the prevalence, hemodynamic profile and prognosis of SCD-PH remain controversial and need frequent updates. Pulmonary hypertension determined by right heart catheterization (RHC) occurs in 6% to 10% of adults with SCD. Hemodynamically, SCD-PH may be pre-capillary or post-capillary in nature. The exact etiology is unknown and often multifactorial; hence a thorough diagnostic evaluation following established PH guidelines is essential to determine disease prevalence, etiology and outcomes...
October 20, 2016: Ethnicity & Disease
Erin Koffel, Imran S Khawaja, Anne Germain
Sleep disturbances are common in adults with PTSD and range from insomnia and nightmares to periodic leg movements and disruptive nocturnal behaviors. Together these findings suggest profound disturbances in rapid eye movement (REM) and non-REM (NREM) sleep, although there is a lack of consensus regarding a distinct profile of objective sleep disturbances associated with PTSD. Prospective, longitudinal studies have established that sleep disturbances represent a risk factor for the development and course of PTSD, suggesting that sleep is an important neurobiological mechanism in the etiology and maintenance of this disorder...
March 2016: Psychiatric Annals
Ken M Kunisaki, Dennis E Niewoehner, Gary Collins, Bitten Aagaard, Nafisah B Atako, Elzbieta Bakowska, Amanda Clarke, Giulio Maria Corbelli, Ernest Ekong, Sean Emery, Elizabeth B Finley, Eric Florence, Rosa M Infante, Cissy M Kityo, Juan Sierra Madero, Daniel E Nixon, Ellen Tedaldi, Jørgen Vestbo, Robin Wood, John E Connett
BACKGROUND: Observational data have been conflicted regarding the potential role of HIV antiretroviral therapy (ART) as a causative factor for, or protective factor against, COPD. We therefore aimed to investigate the effect of immediate versus deferred ART on decline in lung function in HIV-positive individuals. METHODS: We did a nested substudy within the randomised, controlled Strategic Timing of Antiretroviral Treatment (START) trial at 80 sites in multiple settings in 20 high-income and low-to-middle-income countries...
October 20, 2016: Lancet Respiratory Medicine
Landon W Trost, Ricardo Munarriz, Run Wang, Allen Morey, Laurence Levine
INTRODUCTION: The field of sexual medicine is continuously advancing, with novel outcomes reported on a regular basis. Given the rapid evolution, updated guidelines are essential to inform practicing clinicians on best practices. AIM: To summarize the current literature and provide clinical guidelines on penile traction therapy, vacuum erection devices, and penile revascularization. METHODS: A consensus panel was held with leading sexual medicine experts during the 2015 International Consultation on Sexual Medicine (ICSM)...
November 2016: Journal of Sexual Medicine
Maria Celeste Buompadre, Kathleen Andres, Lee-Anne Slater, Hadi Mohseni-Bod, Anne-Marie Guerguerian, Helen Branson, Suzanne Laughlin, Derek Armstrong, Mahendranath Moharir, Gabrielle deVeber, Tilman Humpl, Osami Honjo, Shaf Keshavjee, Rebecca Ichord, Vitor Pereira, Nomazulu Dlamini
The updated American Heart Association/American Stroke Association guidelines include recommendation for thrombectomy in certain adult stroke cases. The safety and efficacy of thrombectomy in children are unknown. An 8-year-old girl experienced acute stroke symptoms on two occasions while therapeutically anticoagulated on Novalung. Computed tomography scans showed proximal vessel thrombi, which were retrieved using a Trevo device without hemorrhagic complications. Postprocedural assessment found respective decreases in the National Institutes of Health Stroke Scale score from 10 to 4 and 12 to 7...
September 14, 2016: Pediatric Neurology
Tessa Strain, Claire Fitzsimons, Paul Kelly, Nanette Mutrie
BACKGROUND: In 2011, the UK physical activity guidelines were updated to include recommendations for muscle strengthening and balance & coordination (at least two sessions of relevant activities per week). However, monitoring and policy efforts remain focussed on aerobic activity. This study aimed to assess differences by gender and age in the a) prevalence of muscle strengthening and balance & co-ordination guidelines, and b) participation in guideline-specific activities. METHODS: The sample for the muscle strengthening analyses was 10,488 adult (16-64 years) and 3857 older adult (≥65 years) 2012-2014 Scottish Health Survey respondents...
October 21, 2016: BMC Public Health
James Raftery, Steve Hanney, Trish Greenhalgh, Matthew Glover, Amanda Blatch-Jones
BACKGROUND: This report reviews approaches and tools for measuring the impact of research programmes, building on, and extending, a 2007 review. OBJECTIVES: (1) To identify the range of theoretical models and empirical approaches for measuring the impact of health research programmes; (2) to develop a taxonomy of models and approaches; (3) to summarise the evidence on the application and use of these models; and (4) to evaluate the different options for the Health Technology Assessment (HTA) programme...
October 2016: Health Technology Assessment: HTA
James Demetrios Douketis
The American College of Chest Physicians recently updated their practice guidelines for the treatment of patients with venous thromboembolism, comprising deep vein thrombosis and pulmonary embolism. The 2016 guidelines represent the tenth iteration of these guidelines, which are widely used, and are considered as the reference standard for practice guidelines related to venous thromboembolism. The objectives of this review are to highlight the key recommendations that are new in these guidelines, to address recommendations that may be considered controversial, and to touch on areas of ongoing research that may better inform some of these recommendations...
October 20, 2016: Internal and Emergency Medicine
Siavash Piran, Sam Schulman
Venous thromboembolism (VTE), which constitutes pulmonary embolism and deep vein thrombosis, is a common disorder associated with significant morbidity and mortality. Landmark trials have shown that direct oral anticoagulants (DOACs) are as effective as conventional anticoagulation with vitamin K antagonists (VKA) in prevention of VTE recurrence and associated with less bleeding. This has paved the way for the recently published guidelines to change their recommendations in favor of DOACs in acute and long-term treatment of VTE in patients without cancer...
2016: Thrombosis Journal
H G Schnürch, S Ackermann, C D Alt, J Barinoff, C Böing, C Dannecker, F Gieseking, A Günthert, P Hantschmann, L C Horn, R Kürzl, P Mallmann, S Marnitz, G Mehlhorn, C C Hack, M C Koch, U Torsten, W Weikel, L Wölber, M Hampl
Purpose: This is an official guideline, published and coordinated by the Arbeitsgemeinschaft Gynäkologische Onkologie (AGO, Study Group for Gynecologic Oncology) of the Deutsche Krebsgesellschaft (DKG, German Cancer Society) and the Deutsche Gesellschaft für Gynäkologie und Geburtshilfe (DGGG, German Society for Gynecology and Obstetrics). The number of cases with vulvar cancer is on the rise, but because of the former rarity of this condition and the resulting lack of literature with a high level of evidence, in many areas knowledge of the optimal clinical management still lags behind what would be required...
October 2016: Geburtshilfe und Frauenheilkunde
Charlotte L Allan, Sophie Behrman, Nina Baruch, Klaus P Ebmeier
Most people with mild dementia can continue to drive, but dementia is progressive and many patients and clinicians will be faced with questions about driving safety in the course of their illness. Determining when this happens is a complex decision, with risks of personal and public safety needing to be weighed against individual patient benefits of driving in terms of autonomy, independence and well-being. Decisions need to make reference to cognitive abilities, as well as other factors including physical comorbidity, vision, mobility, insight and history of driving errors and accidents...
October 20, 2016: Evidence-based Mental Health
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